Arterial stiffness and left ventricular structure assessed by cardiac computed tomography in a multiethnic population

Arterial stiffness expressed by cardio-ankle vascular index (CAVI) is a marker of arteriosclerosis. It can increase vascular load, which in turn may affect the viscoelastic myocardial properties and the left ventricular compliance. In the present study, we sought to investigate the association between CAVI and left ventricular structure assessed by cardiac computed tomography (CT) in a multiethnic adult cohort.

CAVI was measured using the vascular screening system VaSera VS-1500 AU (Fukuda Denshi, Japan). The average of right and left CAVI values was utilized for the analysis. Left ventricular mass and volume were computed on mid-diastolic cardiac CTA images and indexed to body surface area (BSA) to obtain left ventricular mass index (LVMI) and left ventricular volume index (LVVI). The association between CAVI, LVMI and LVVI was assessed by multiple linear regression analysis.

The study cohort was composed of 255 individuals (mean age 56.2 ± 13.4, 66% men). An abnormal CAVI value was defined as at least 8. One hundred and seventy-one individuals had CAVI values at least 8: they were older (P < 0.0001), more affected by of hypertension (P < 0.0001), dyslipidaemia (P = 0.0002), diabetes mellitus (P < 0.0001), previous history of myocardial infarction (P = 0.0246) or angioplasty (P = 0.0143), had higher CAC score (P < 0.0001) and prevalence of obstructive coronary artery disease (P = 0.001). When analysing CT-derived left ventricular geometry parameters, we found that individuals with abnormal CAVI had significantly smaller LVVI (P < 0.0001). This association remained valid after adjustments for age, sex, ethnicity (P = 0.0002), hypertension, dyslipidaemia, CAC score (P = 0.0004) and diabetes mellitus (P = 0.0034). The association between abnormal CAVI and LVMI was not significant in the unadjusted model (P = 0.593).

Reduced vascular distensibility in an adult multiethnic population is associated with smaller LVVI beyond traditional cardiovascular risk factors suggesting that impaired left ventricular compliance mainly parallels increased arterial stiffness.